JOURNAL ARTICLE

Relationship Between the Duration of Cardiopulmonary Resuscitation and Favorable Neurological Outcomes After Out-of-Hospital Cardiac Arrest: A Prospective, Nationwide, Population-Based Cohort Study

Yoshikazu Goto, Akira Funada, Yumiko Goto
Journal of the American Heart Association 2016 March 18, 5 (3): e002819
26994129

BACKGROUND: The determination of appropriate duration of in-the-field cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients is one of the biggest challenges for emergency medical service providers and clinicians. The appropriate CPR duration before termination of resuscitation remains unclear and may differ based on initial rhythm. We aimed to determine the relationship between CPR duration and post-OHCA outcomes.

METHODS AND RESULTS: We analyzed the records of 17 238 OHCA patients (age ≥18 years) who achieved prehospital return of spontaneous circulation. Data were prospectively recorded in a nationwide, Japanese database between 2011 and 2012. The time from CPR initiation to prehospital return of spontaneous circulation (CPR duration) was calculated. The primary end point was 1-month survival with favorable neurological outcomes (Cerebral Performance Category [CPC] scale; CPC 1-2). The 1-month CPC 1-2 rate was 21.8% (n=3771). CPR duration was inversely associated with 1-month CPC 1-2 (adjusted unit odds ratio: 0.95, 95% CI: 0.94-0.95). Among all patients, a cumulative proportion of >99% of 1-month CPC 1-2 was achieved with a CPR duration of 35 minutes. When sorted by the initial rhythm, the CPR duration producing more than 99% of survivors with CPC 1-2 was 35 minutes for shockable rhythms and pulseless electrical activity, and 42 minutes for asystole.

CONCLUSIONS: CPR duration was independently and inversely associated with favorable 1-month neurological outcomes. The critical prehospital CPR duration for OHCA was 35 minutes in patients with initial shockable rhythms and pulseless electrical activity, and 42 minutes in those with initial asystole.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
26994129
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"